Abstract 459

Background: Few emergency departments (EDs) in the US provide formal asthma teaching. Such teaching has been emphasized as an essential component of the National Asthma Education and Prevention Program (NAEPP). While literacy and the reading level of discharge instructions have been identified as barriers in ED education, videotaped information has been shown to be effective in increasing short-term knowledge in other settings.

Objective: To evaluate the effectiveness of two forms of asthma education in the pediatric emergency department.

Methods: A randomized, controlled, prospective study was conducted in the pediatric ED of an urban teaching hospital. A questionnaire was administered to parents of patients with a previous diagnosis of asthma to assess baseline knowledge in four categories related to asthma. They were then given either an asthma handout developed by the NAEPP or a professionally produced pediatric asthma education videotape. Study participants were blinded to the study objectives until after the postintervention questionnaire. Raw scores were calculated as the number of correct responses out of 20 questions.

Results: 48 parents were enrolled in the control/handout group and 58 in the intervention/video group. The groups were equal with regard to level of education (p=.64) and relationship to the patient (p=.39) The mean baseline and discharge scores for the control group were 13.2 and 12.1. (p=.39) Those for the intervention group were 13.1 and 13.1. (p=.43). There was no significant difference in baseline or discharge scores between the groups. Many significant misconceptions about asthma were noted on both questionnaires including 53% of respondants who felt that asthma medications are addictive, 53% who believed that cough medicine is the appropriate therapy for cough in asthmatic children and 39% who responded that asthma is an infection.

Conclusion: A videotape education intervention produced no additional knowledge in parents of asthmatic children either alone or in comparison to a standard asthma handout. Other factors, such as accompaniment by other children and the high levels of noise and stress of an ED visit may preclude effective educational interventions in this setting. In addition, our survey identified important misconceptions about asthma and its treatment for many parents. Some of these misconceptions may need to be clarified in ED discharge teaching. Further study is needed to identify an effective method of ED asthma teaching.